Suspect overbilling for healthcare services under Medicare and Medicaid?
Don’t stay silent. We know how to protect brave whistleblowers in North & South Carolina who speak out against overbilling services fraud.
Healthcare providers working with Medicare and Medicaid are entrusted with delivering quality medical care while adhering to strict billing practices. Unfortunately, some providers exploit the system through fraudulent overbilling of services – cheating taxpayers, patients, and legitimate providers.
Have you observed medical billing codes that seem inflated for the actual services provided?
Do you know of a healthcare provider who submits multiple bills for the same service or who bills for services not performed?
These are types of Medicaid and Medicare services overbilling fraud, and we can help you blow the whistle on it in North and South Carolina.
We know how to guide and protect you. Contact us today at 1-888-292-8852 for a free, confidential discussion that can give you peace of mind and help you decide how you want to proceed.
What is overbilling for healthcare services?
Overbilling for healthcare services occurs when healthcare providers submit inaccurate or inflated claims to Medicare and Medicaid to receive higher reimbursements than they are entitled to. This unethical practice can take many forms and is considered a type of healthcare fraud.
What are some examples of overbilling fraud for healthcare services?
Greedy healthcare providers have discovered many ways to overbill Medicare and Medicaid for services, including:
- Billing for unnecessary medical tests or services, such as ordering multiple diagnostic tests that aren’t required for treatment or diagnosis
- Duplicate billing, or submitting multiple claims for the same service
- Altering medical records, such as falsifying a patient’s diagnosis to justify unnecessary services
- Misrepresenting patient diagnoses to justify unnecessary services
- Submitting false claims such as for deceased patients
- Inflating time-based services, such as overstating the time spent in therapy or consultations
- Misusing transportation benefits designated for medical purposes for non-medical activities
- Upcoding and unbundling are forms of billing for more than the services rendered
If you suspect or have information about a healthcare service provider intentionally committing Medicare or Medicaid overbilling services fraud, contact us for a free and confidential case evaluation by calling 1-888-292-8852 now.
Upcoding: A major type of Medicare & Medicaid services overbilling fraud
Upcoding is a specific type of services overbilling fraud in which the healthcare provider uses a billing code for a more expensive service than the service actually performed. For example, a provider might upcode by billing Medicare or Medicaid for a high-level, comprehensive, extensive doctor visit when the patient actually only received a routine check-up.
Unbundling involves overbilling for healthcare services
Unbundling, a common type of Medicaid and Medicare services overbilling fraud, occurs when a healthcare provider breaks down a single medical service into smaller, separately billed service codes which results in a higher overall charge to Medicare or Medicaid. Another example of unbundling is when a provider bills for both a major and minor service separately, even though the major service code includes the minor service.
How can I report suspected Medicare/Medicaid overbilling fraud, and how can a whistleblower attorney help?
A whistleblower attorney can help you report Medicare and Medicaid services overbilling fraud by filing a qui tam lawsuit on behalf of the government under the False Claims Act. This involves:
- Evaluating the evidence
- Building your case
- Filing a qui tam lawsuit under the False Claims Act
- Coordinating with the government in the investigation of the overbilling fraud allegations
- Hopefully reaching a successful resolution to the government’s case
- Negotiating with the government to try to get you the maximum award – up to 30% of any government recovery
- Advocating on your behalf throughout the whistleblowing process
Why is overbilling for medical services considered fraudulent?
Overcharging the government for healthcare services is not a victimless crime. Medicaid and Medicare overbilling fraud involves intentional deception for illegal financial gain and undermines the integrity of healthcare systems including accurate billing and fair use of resources.
Overbilling for medical services scams increase costs for the public, undermine patient care, and erode patient confidence in healthcare providers.
How Carolina Whistleblower Attorneys can help you fight Medicare and Medicaid services overbilling fraud
If you suspect Medicare or Medicaid services overbilling fraud and are considering taking steps to expose it, it’s important to know your rights. And we can help. Our whistleblower team is led by former U.S. Attorney Bill Nettles. During his tenure, Bill led South Carolina to become one of the top four states in the nation for whistleblower recoveries.1,4
Our mission is to expose fraud against the government, and we stand with those who have the courage to report all types of medical billing fraud involving Medicare and Medicaid. Our client success stories prove our dedication to seeking justice.1,4
We operate on a contingency fee basis, which means we cover all the costs of building your case, and you don’t pay a penny unless we win an award for you—guaranteed.2 With our You-First Policy, your interests come first every step of the way.
Whistleblowers play a critical role in identifying services overbilling schemes. If you suspect Medicare or Medicaid healthcare billing fraud, let’s have a confidential conversation. We can answer your questions and help you explore your options. The consultation is free, and there’s no obligation.
Contact us online or call 1-888-292-8852 today!
Awards we’ve won
For standards of inclusion for awards listed, visit bestlawyers.com, thenationaltriallawyers.org, superlawyers.com, farrin.com/business-nc-power-list, and millondollaradvocates.com. National Trial Lawyers Top 100 designation is for 2025. Regarding the Million Dollar Advocates Forum, we do not represent that similar results will be achieved in your case. Each case is different and must be evaluated separately. Firm award is for the Law Offices of James Scott Farrin. Attorney awards are for attorneys with the Law Offices of James Scott Farrin.
Contact the Carolina
Whistleblower Attorneys
If you’re wondering if it’s a good idea to speak with a whistleblower lawyer about what you know, let us set the record straight.
- Corporate ethics hotlines can be risky and may lead to termination. If you’ve already done this, call us immediately.
- Your coworkers could be aware of the fraud – or complicit in it – and you should not talk to them about it.
- The first claim to be filed under the False Claims Act can proceed – if you’re not first, you’re at a serious disadvantage and may get nothing (another reason not to speak to your coworkers about it).
- A confidential discussion costs you a few minutes, but could save you time, stress, and money.
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